#HPM - TweetChat - 2/13/13

2/14/13
#hpm - Healthcare Social Media Transcript
#hpm transcript
Healthcare Social Media Transcript
From: To: Wed Feb 13 18:00:00 PST 2013 Wed Feb 13 19:15:00 PST 2013 change time period
Who were the influencers during this time period? #hpm analytics Connecting the dots in healthcare social media: Healthcare Conference - Tweet Chats - Healthcare Analytics What is #hpm?
KnowYourWishes
Ditto MT @aliciabloom: for the next hour, i'll be in #hpm chat. so you can expect lots of #hospice & #palliative care tweets from me.
Wed Feb 13 18:01:07 PST 2013
aliciabloom
welcome to #hpm tweetchat! let's get started with some introductions. . .

Wed Feb 13 18:01:08 PST 2013
hospice_mktg
Hi! It's Emily Barry with Transcend Hospice Marketing Group. #hpm
Wed Feb 13 18:01:56 PST 2013
KnowYourWishes
LJ Van Scoy, MD. Pulmonary/critical care doc. Interest in EOL in the ICU. Author of Last Wish-stories to inspire a peaceful passing #hpm
Wed Feb 13 18:02:34 PST 2013
SWChelsea06
Hi @aliciabloom & @KnowYourWishes- This is Chelsea, LISW from eFuneral back for more @eFuneral #hpm
Wed Feb 13 18:02:43 PST 2013
Kamiyamay
Hpm in motion. Lurking mostly. #hpm

Wed Feb 13 18:02:51 PST 2013
aliciabloom
welcome @hospice_mktg and @knowyourwishes! great to have you both here #hpm
Wed Feb 13 18:02:52 PST 2013
hashtags.symplur.com/healthcare-hashtag-transcript.php?hashtag=hpm&fdate=02-13-2013&shour=18&smin=0&tdate=02-13-2013&thour=19&tmin=15&ssec=0
1/22
2/14/13
ctsinclair
Hello everyone! Will be joining #hpm chat from the air in a little bit. Coughing kids and screaming babies say hello!
Wed Feb 13 18:03:23 PST 2013
aliciabloom
@Kamiyamay glad to have you lurking, hopefully you can join in a bit! #hpm
Wed Feb 13 18:03:57 PST 2013
TheBiopsy
Roheet here! Lurking at #hpm chat. There seems to be a lot of Twitter chats going on tonight!
Wed Feb 13 18:04:08 PST 2013
NursSciWatch
RT @abbrody: New York Area Hospitals introduce the palliative care bundle, a checklist for identifying and providing care #hpm http://t. ...
Wed Feb 13 18:04:44 PST 2013
hospice_mktg
Hopefully it's not a long flight @ctsinclair ... coughing kids and screaming babies in a confined space can't be pretty for long! #hpm
Wed Feb 13 18:04:44 PST 2013
aliciabloom
welcome @TheBiopsy! feel free to join in the discussion #hpm

Wed Feb 13 18:04:45 PST 2013
moyecome
RT @hollyby: MT @ScrippsHealth: Discover how Scripps hopes to help @SanDiegoHospice patients and staff... http://t.co/ud4cX1mY. #hpm #ho ...
Wed Feb 13 18:04:47 PST 2013
KnowYourWishes
@TheBiopsy Hi Roheet. Great name for a medical blog! #hpm

Wed Feb 13 18:04:56 PST 2013
ctsinclair
Intro: Christian Sinclair, National Hospice Medical director for Gentiva, frequent flyer. Editor for @Pallimed #hpm
Wed Feb 13 18:05:30 PST 2013
TheBiopsy
@KnowYourWishes Why, thank you! #hpm

Wed Feb 13 18:05:54 PST 2013
TexasKidDoc
Joining today from the cardiology call room. Let's see how long I can last in here... #Hpm
Wed Feb 13 18:05:58 PST 2013
NursSciWatch
RT @DianeEMeier: For Some Caregivers, the Trauma Lingers http://t.co/x3ocr3Jd #palliative #hpm esp. if patient gets care in ICU or hosp ...
Wed Feb 13 18:06:06 PST 2013
aliciabloom
hey @ctsinclair! #hpm

Wed Feb 13 18:06:09 PST 2013
2/22
2/14/13
ctsinclair
Airplane doors are closed. Gotta turn off my phone but will join you soon. See ya tweeps. #hpm
Wed Feb 13 18:06:25 PST 2013
Kamiyamay
@aliciabloom safety first. :-) know it will be A great hour. #hpm

Wed Feb 13 18:06:34 PST 2013
KnowYourWishes
@TexasKidDoc Good luck with that!! #hpm

Wed Feb 13 18:06:35 PST 2013
TexasKidDoc
Current pediatric resident going into nicu and #pedpc #Hpm

Wed Feb 13 18:06:46 PST 2013
aliciabloom
@TexasKidDoc hopefully long enough to join us for chat! #hpm

Wed Feb 13 18:06:57 PST 2013
NursSciWatch
RT @nurse2103: Suffering Assessment: A Review of Available Instruments for Use in Palliative Care http://t.co/r0rquHaS #hpm
Wed Feb 13 18:07:18 PST 2013
CSlaterMD
Hello there, internist, first time here, really lurking and learning #hpm
Wed Feb 13 18:08:52 PST 2013
KnowYourWishes
@CSlaterMD Welcome! #hpm

Wed Feb 13 18:09:22 PST 2013
nursefriendly
Yes :( but there is also #hpm #dmsa #addictionchat #premeded that started at 9pm :) #ivchat
Wed Feb 13 18:09:37 PST 2013
aliciabloom
T1- Dr. @JoanMTeno just published an important study on utilization of hospice. Read a great summary here: http://t.co/V2besrqt #hpm
Wed Feb 13 18:09:50 PST 2013
TexasKidDoc
Wanted to share "hospice!? What good would that do!? That's for when you have 2 wks to live!"convo I had recently w/ peeps who get it #Hpm
Wed Feb 13 18:09:59 PST 2013
aliciabloom
@CSlaterMD welcome! great to have you here. please join in the discussion! #hpm
Wed Feb 13 18:10:14 PST 2013
marlenatang
Hello #hpm. ER doctor from California here

Wed Feb 13 18:10:46 PST 2013
aliciabloom
@marlenatang welcome! glad to have you join us. #hpm

Wed Feb 13 18:11:16 PST 2013
3/22
2/14/13
nursefriendly
Hello Everyone, Andrew Lopez, RN from New Jersey #hpm

Wed Feb 13 18:11:17 PST 2013
CSlaterMD
@KnowYourWishes @aliciabloom TYVM! Already see some friendly faces! @nursefriendly @Kamiyamay #hpm
Wed Feb 13 18:11:29 PST 2013
aliciabloom
T1- give a read to the LA Times summary and share some initial reactions. . . #hpm
Wed Feb 13 18:11:37 PST 2013
hospice_mktg
The @JoanMTeno study has gotten great coverage. Hopefully it will be a catalyst for change in #hospice and #eol care. #hpm
Wed Feb 13 18:12:15 PST 2013
mdTalk
Airplane doors are closed. http://t.co/Wwuq2Sa1 Gotta turn off my phone but will join you soon. See ya tweeps. #hpm
Wed Feb 13 18:12:55 PST 2013
MerynFry
RT @DianeEMeier: For Some Caregivers, the Trauma Lingers http://t.co/x3ocr3Jd #palliative #hpm esp. if patient gets care in ICU or hosp ...
Wed Feb 13 18:13:23 PST 2013
nursefriendly
T1 Not surprising that many patients endure aggressive therapies in their last days, even though they would prefer otherwise. #hpm
Wed Feb 13 18:13:44 PST 2013
nursefriendly
T1 Have to wonder how many of these #patients have made their wishes known, had living wills, #advancedirectives #hpm
Wed Feb 13 18:14:19 PST 2013
aliciabloom
T1- an increase in hospice utilization seems promising, when you see the shorter lengths of stay, it's eye opening #hpm
Wed Feb 13 18:14:37 PST 2013
hospice_mktg
"latest research suggests patients' wishes may not be getting through to family members &physicians who help guide patients' eol." #hpm
Wed Feb 13 18:14:42 PST 2013
TexasKidDoc
T2 - very interesting it's not two divergent paths #Hpm

Wed Feb 13 18:14:51 PST 2013
nursefriendly
T1 When #patients #families #caregivers are on the same page, informed of options including #hospice, #doctors will listen. #hpm
Wed Feb 13 18:14:56 PST 2013
KnowYourWishes
T1 Haven't poured through paper in detail yet but % seems low - 29% die in ICU. Granted i have very biased experience being ICU doc. #hpm
Wed Feb 13 18:15:45 PST 2013
4/22
2/14/13
hospice_mktg
Agree w/ @nursefriendly ... people need to clearly communicate their wishes for care and support early and often #hpm
Wed Feb 13 18:15:51 PST 2013
nursefriendly
T1 The fact the are "Enduring aggressive treatment" indicates a strong need of education, shortcoming with doctors explaining options #hpm
Wed Feb 13 18:16:10 PST 2013
hospice_mktg
RT @nursefriendly: T1 When #patients #families #caregivers are on same pg, informed of options inc #hospice, #doctors will listen. #hpm
Wed Feb 13 18:16:27 PST 2013
nursefriendly
T1 Brings up the question, when is the right time to discuss less aggressive therapies. Will they be mentioned routinely? #hpm
Wed Feb 13 18:17:00 PST 2013
AnnoyingTris
RT @TexasKidDocT2 - very interesting it's not two divergent paths #Hpm http://t.co/WHPNF8jg
Wed Feb 13 18:17:02 PST 2013
CSlaterMD
Is it a HIPAA prob or a communication prob? @hospice_mktg "latest research suggests patients' wishes may not be getting thru... #hpm
Wed Feb 13 18:17:10 PST 2013
aliciabloom
T1- hospitals often move patients out of ICU to general medical floors before imminent death; may account for low % of deaths there #hpm
Wed Feb 13 18:17:12 PST 2013
KnowYourWishes
T1 "Disruptive moves" interesting measurement. Like it. Would like to know % of people who went from hospice to ER/hospital/ICU. #hpm
Wed Feb 13 18:17:22 PST 2013
SWChelsea06
A pt today who refused to complete living will and Health Care Power of Attorneyfrustrating- kept saying- "They'll know what I want." #hpm
Wed Feb 13 18:17:29 PST 2013
nursefriendly
T1 Has been my experience that #hospice #palliative are almost exclusively offered in oncology, or at #patient #family request #hpm
Wed Feb 13 18:17:39 PST 2013
aliciabloom
@CSlaterMD I suspect it's a communication problem #hpm

Wed Feb 13 18:17:49 PST 2013
buendia65
RT @AAHPM: AMA Issues 5 Patient Safety Guidelines http://t.co/bhXCBDxO via @sharethis #hpm
Wed Feb 13 18:17:52 PST 2013
KnowYourWishes
@aliciabloom excellent point #hpm
5/22
2/14/13

Wed Feb 13 18:17:53 PST 2013
nursefriendly
T1 If a #patient #family #caregiver does not bring up #hospice #palliative options, when will it be brought up, will it at all? #hpm
Wed Feb 13 18:18:24 PST 2013
hospice_mktg
A comm problem on many fronts RT @aliciabloom: @CSlaterMD I suspect its a communication problem #hpm
Wed Feb 13 18:18:31 PST 2013
CSlaterMD
@aliciabloom its true, been a while for me now but used to almost be like real estate, the ICU beds #hpm
Wed Feb 13 18:18:41 PST 2013
KnowYourWishes
Agree. in my experience HIPPA less of issue in #eol realm RT @aliciabloom: @CSlaterMD I suspect it's a communication problem #hpm
Wed Feb 13 18:19:21 PST 2013
nursefriendly
@SWChelsea06 Can see how #patients would not want to approach it in a crisis, must be done long before, but isn't usually. #hpm
Wed Feb 13 18:19:29 PST 2013
PracticalWisdom
Patients wishes not be honored: Discussed #greatchallenges http://t.co/EeeAgVfK @TEDMED @CSlaterMD @hospice_mktg #HPM
Wed Feb 13 18:20:05 PST 2013
hospice_mktg
Patients and families need to know they have a choice when it comes to #hospice, #palliative care. They can choose even if doc hasn't #hpm
Wed Feb 13 18:20:12 PST 2013
ReginaHolliday
RT @PracticalWisdom: Patients wishes not be honored: Discussed #greatchallenges http://t.co/EeeAgVfK @TEDMED @CSlaterMD @hospice_mktg #HPM
Wed Feb 13 18:20:55 PST 2013
CSlaterMD
@PracticalWisdom @TEDMED @hospice_mktg Lisa, TY. amazing u are. #hpm

Wed Feb 13 18:21:17 PST 2013
hospice_mktg
Even if patients have shared their wishes, families many not agree and follow through #hpm
Wed Feb 13 18:21:18 PST 2013
aliciabloom
T1- i think we're often quick to blame clinicians for not starting the conversations, but we need families to be receptive #hpm
Wed Feb 13 18:21:19 PST 2013
ReginaHolliday
@nursefriendly @SWChelsea06 I was just on @MyDirectives today updating mine :) #hpm

Wed Feb 13 18:21:41 PST 2013
6/22
2/14/13
KnowYourWishes
TRIPLE RT @aliciabloom: T1- we're often quick to blame clinicians for not starting the conversations, need families to be receptive #hpm
Wed Feb 13 18:22:17 PST 2013
ReginaHolliday
@aliciabloom the problem is a default assumption that we don't want to talk. #hpm
Wed Feb 13 18:22:18 PST 2013
KnowYourWishes
T1 Clinicians afraid to 'upset' patient perhaps reason for avoidance #hpm

Wed Feb 13 18:22:48 PST 2013
SWChelsea06
@ReginaHolliday @nursefriendly @MyDirectives Great Resource! I've never seen that #hpm
Wed Feb 13 18:22:48 PST 2013
nursefriendly
@ReginaHolliday Hello Regina :) It is not a topic people like to think about, much less do something about. #hpm
Wed Feb 13 18:22:51 PST 2013
nursefriendly
See that every day :( RT @hospice_mktg: Even if patients have shared their wishes, families many not agree and follow through #hpm
Wed Feb 13 18:23:24 PST 2013
ReginaHolliday
@hospice_mktg hence why you need a strong advocate and a clear directive, and supportive provider if possible. #hpm
Wed Feb 13 18:23:24 PST 2013
hospice_mktg
RT @KnowYourWishes: T1 Clinicians afraid to upset patient perhaps reason for avoidance / also don't want to give up pt's hope #hpm
Wed Feb 13 18:23:36 PST 2013
aliciabloom
@ReginaHolliday don't think that's always a barrier. as a palliative care clinician, i can say that many stop conversation as it starts #hpm
Wed Feb 13 18:23:42 PST 2013
CSlaterMD
@ReginaHolliday @aliciabloom HC is still one directional. need to dissolve the silence and start talking about it. guilty as charged #hpm
Wed Feb 13 18:23:49 PST 2013
PracticalWisdom
Is it too late to jump in? I'm working but saw this important topic. #HPM
Wed Feb 13 18:23:52 PST 2013
PracticalWisdom
RT @ReginaHolliday: @hospice_mktg hence why you need a strong advocate and a clear directive, and supportive provider if possible. #HPM
Wed Feb 13 18:24:01 PST 2013
aliciabloom
T1- there are many reasons the conversations don't happen, but patients/families need to be empowered to speak up! #hpm
Wed Feb 13 18:24:33 PST 2013
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aliciabloom
@PracticalWisdom no, it's never too late. we're discussing Joan Teno's newly published study. #hpm
Wed Feb 13 18:24:55 PST 2013
nursefriendly
Many are gunshy yes. RT @KnowYourWishes: T1 Clinicians afraid to upset patient perhaps reason for avoidance #hpm
Wed Feb 13 18:25:11 PST 2013
thanec
Wed Feb 13 18:25:21 PST 2013
ReginaHolliday
@SWChelsea06 @nursefriendly @MyDirectives is really cool! Emails your care team :) Great for folks like me with no spouse. #hpm
Wed Feb 13 18:25:26 PST 2013
Sarah_Hewko
Wed Feb 13 18:26:15 PST 2013
KnowYourWishes
Fam needs 2 b open, trusting of clinicians' http://t.co/GqBnnwsO ICU, often met w suspicion, anger (from grief) which makes convos hard #hpm
Wed Feb 13 18:26:29 PST 2013
nursefriendly
@aliciabloom T1 Where are families supposed to learn about #palliative #hospice as options is their providers don't every bring up? #hpm
Wed Feb 13 18:26:41 PST 2013
ReginaHolliday
@aliciabloom I am not talking case by case, but a cultural presumption Re: Letting Go/ Atul Gawande #hpm
Wed Feb 13 18:27:11 PST 2013
aliciabloom
@nursefriendly it's not about asking for those things specifically, but it's asking about options & speaking up re: values/preferences #hpm
Wed Feb 13 18:27:29 PST 2013
nursefriendly
@ReginaHolliday Never heard of it before @mydirectives will need to check it out :) #hpm
Wed Feb 13 18:27:31 PST 2013
PracticalWisdom
@aliciabloom Dr. Joan Teno http://t.co/JnSQswZ0 is gives practical insight in the @TEDMED @YOUTube #HPM
Wed Feb 13 18:27:43 PST 2013
ctsinclair
RT @aliciabloom: T1- were often quick to blame clinicians for not starting the conversations, need families to be receptive #hpm
Wed Feb 13 18:27:57 PST 2013
aliciabloom
@ReginaHolliday i'm very familiar & agree there are some larger cultural issues, but
8/22
2/14/13
at the end of the day it is the case by case #hpm

Wed Feb 13 18:28:11 PST 2013
ctsinclair
Can someone RT the first topic? #hpm

Wed Feb 13 18:28:13 PST 2013
TexasKidDoc
It's even nice while it lasted - have an admission to do! Enjoy the rest of the chat guys! #Hpm
Wed Feb 13 18:28:20 PST 2013
nursefriendly
@aliciabloom T1 Doctors are already notorious about not explaining all options for surgery, treatments, can't see many including EOL #hpm
Wed Feb 13 18:29:06 PST 2013
PracticalWisdom
T1: Dr. Joan Teno Quote "If you don't make a plan you've made a Decision." http://t.co/EeeAgVfK #HPM
Wed Feb 13 18:29:36 PST 2013
aliciabloom
@nursefriendly it's not just about EoL though, and we've got to stop making just about that. it's much bigger than that. #hpm
Wed Feb 13 18:29:50 PST 2013
hospice_mktg
@nursefriendly @aliciabloom Hopefully local hospices are educating their communities, phys and referrers about hospice care, svs avail #hpm
Wed Feb 13 18:29:55 PST 2013
aliciabloom
@ctsinclair we're talking about Joan Teno's recently published study. i sent a link to an LA Times summary. #hpm
Wed Feb 13 18:30:11 PST 2013
nursefriendly
@aliciabloom Elaborate please . . . #hpm

Wed Feb 13 18:31:04 PST 2013
marlenatang
@KnowYourWishes Yes, and in the ER, shock and disbelief of the whole situation #hpm
Wed Feb 13 18:31:13 PST 2013
ctsinclair
T1: In an era of more patient empowerment, there is usually a bias towards asking about what more can be done, not about should we act #hpm
Wed Feb 13 18:31:22 PST 2013
KnowYourWishes
T1 Studies show pts prefer to talk about #eol and ADs in attorneys office. Pts do NOT want to talk about it w/ docs (wish i had cite) #hpm
Wed Feb 13 18:31:32 PST 2013
ctsinclair
What surprised me is that 40% of patients 30 days before death had no home services. #hpm
Wed Feb 13 18:31:51 PST 2013
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nursefriendly
@hospice_mktg You would like to think so, yet how many doctor seek out information on #hospice #palliative care, CEUs? #hpm
Wed Feb 13 18:32:10 PST 2013
ctsinclair
T1: I would imagine there would be patient and family needs that could be addressed during that time. #hpm
Wed Feb 13 18:32:16 PST 2013
PracticalWisdom
T1: "If you don't make that plan you will see aggressive Life Sustaining Treatment." Dr. Joan Teno Quote http://t.co/EeeAgVfK #HPM
Wed Feb 13 18:33:04 PST 2013
CSlaterMD
but what plan arises from that "decision?" @PracticalWisdom T1: Dr. Joan Teno Quote "If you don't make a plan you've made a Decision" #hpm
Wed Feb 13 18:33:05 PST 2013
aliciabloom
@nursefriendly it's not just about getting people to hospice. more people are enrolling, but late. need discussions WAY upstream. #hpm
Wed Feb 13 18:33:09 PST 2013
aliciabloom
RT @ctsinclair: What surprised me is that 40% of patients 30 days before death had no home services. #hpm
Wed Feb 13 18:33:24 PST 2013
KnowYourWishes
@CSlaterMD @PracticalWisdom Full, aggressive intervention is the "no decision" decision #hpm
Wed Feb 13 18:33:42 PST 2013
aliciabloom
T1- i believe people are not accessing as much routine health care. coming to the hospital much sicker, creating challenging situations #hpm
Wed Feb 13 18:34:11 PST 2013
nursefriendly
@aliciabloom Agreed, #hospice #palliative care options need to be introduced into the discussion long before need arises. #hpm
Wed Feb 13 18:34:37 PST 2013
CSlaterMD
@KnowYourWishes Got it , thanks. no plan sets full press in motion #hpm

Wed Feb 13 18:34:49 PST 2013
hospice_mktg
RT @aliciabloom: @nursefriendly not just abt getting ppl to hospice. more ppl are enrolling, but late. need discussions WAY upstream. #hpm
Wed Feb 13 18:34:52 PST 2013
ctsinclair
FYI Dr. Joan Teno is on Twitter @JoanMTeno #hpm

Wed Feb 13 18:34:56 PST 2013
KnowYourWishes
T1 lost my follow up tweet to my attorneys office tweet-- but essentially, need to move convo out of attorney office #hpm
Wed Feb 13 18:35:05 PST 2013
hashtags.symplur.com/healthcare-hashtag-transcript.php?hashtag=hpm&fdate=02-13-2013&shour=18&smin=0&tdate=02-13-2013&thour=19&tmin=15&ssec=
10/22
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Kamiyamay
@KnowYourWishes u R right. Seen some bad outcomes. How do we make better #hpm
Wed Feb 13 18:35:10 PST 2013
chadreilly
Very true! @aliciabloom MT: it's not just about EoL though, and we've got to stop making just about that. it's much bigger than that. #hpm
Wed Feb 13 18:35:17 PST 2013
aliciabloom
@nursefriendly we shouldn't be talking about it that way. we should be talking about disease trajectory, QoL, values & preferences. #hpm
Wed Feb 13 18:35:28 PST 2013
KnowYourWishes
@Kamiyamay Conversations outside of emergency setting is only way to give TIME for the decisions to be made thoughtfully #hpm
Wed Feb 13 18:35:48 PST 2013
aliciabloom
T1- advance directive conversations do NOT belong in an attorney's office. i completely agree, @knowyourwishes. #hpm
Wed Feb 13 18:36:01 PST 2013
ctsinclair
RT @KnowYourWishes Full, aggressive intervention is the "no decision" decision #hpm "The default of the system" #hpm
Wed Feb 13 18:36:12 PST 2013
Kamiyamay
RT @chadreilly: Very true! @aliciabloom MT: not just about EoL weve got to stop making just about that. its much bigger than that. #hpm
Wed Feb 13 18:36:15 PST 2013
chadreilly
RT @ctsinclair: What surprised me is that 40% of patients 30 days before death had no home services. #hpm
Wed Feb 13 18:36:20 PST 2013
ReginaHolliday
RT @aliciabloom: T1- advance directive conversations do NOT belong in an attorney's office. i completely agree, @knowyourwishes. #hpm
Wed Feb 13 18:36:39 PST 2013
hospice_mktg
Yes, need to be talking about goals of care, QoL ... that's a good way to begin the convo #hpm
Wed Feb 13 18:36:43 PST 2013
aliciabloom
T1- we need to have realistic conversations about disease trajectory from time of diagnosis & then routinely to inform decision making #hpm
Wed Feb 13 18:36:53 PST 2013
ctsinclair
RT @aliciabloom: we should be talking about disease trajectory, QoL, values & preferences. "Much more empowering, validating" #hpm
Wed Feb 13 18:36:58 PST 2013
RT @ctsinclair: RT @KnowYourWishes Full, aggressive intervention is the "no
11/22
2/14/13
ReginaHolliday
decision" decision #hpm "The default of the system" #hpm

Wed Feb 13 18:37:09 PST 2013
KnowYourWishes
Outcome based discussions RT @hospice_mktg: Yes, need to be talking about goals of care, QoL ... that's a good way to begin the convo #hpm
Wed Feb 13 18:37:12 PST 2013
Kamiyamay
@KnowYourWishes UR right. I have been called to too many extinctions on wkd. Not good way at all #hpm
Wed Feb 13 18:37:33 PST 2013
KnowYourWishes
Need to incorporate outcomes of tx, duration and meaningful quality of life #hpm
Wed Feb 13 18:37:45 PST 2013
Kamiyamay
Yikes extubations. RT @Kamiyamay: @KnowYourWishes UR right. I have been called to too many extinctions on wkd. Not good way at all #hpm
Wed Feb 13 18:38:23 PST 2013
marlenatang
@ctsinclair The system also makes it hard to send a patient home from ED with same day hospice services rather than admit. #hpm
Wed Feb 13 18:38:38 PST 2013
aliciabloom
@ctsinclair i think it's more empowering. patients & families feel like they're in control of their lives, not just making hard choices #hpm
Wed Feb 13 18:39:11 PST 2013
CSlaterMD
@Kamiyamay was wondering what u meant! :-) #hpm

Wed Feb 13 18:39:16 PST 2013
nathangradisher
Dr Sinclair-- Thank you for the fyi @ctsinclair: FYI Dr. Joan Teno is on Twitter @JoanMTeno #hpm
Wed Feb 13 18:39:21 PST 2013
KnowYourWishes
YES. ER needs resources RT @marlenatang: @ctsinclair hard 2 send a pt home from ED with same day hospice services rather than admit. #hpm
Wed Feb 13 18:39:34 PST 2013
PracticalWisdom
T1:@JAMA=Dr.Teno http://t.co/yItLhxlX Concern:Both ICU use &% HC transitions +last month of life. #HPm
Wed Feb 13 18:39:40 PST 2013
marlenatang
@ctsinclair once admitted, ball starts rolling if no inpt PC service. Often left with admit as default for pts with few resources #hpm
Wed Feb 13 18:39:46 PST 2013
Kamiyamay
@ReginaHolliday we need a new default a better way. Early advocacy! #hpm

Wed Feb 13 18:39:48 PST 2013
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aliciabloom
i think we need more stories like this out there: http://t.co/DwqGGf9V #hpm
Wed Feb 13 18:40:04 PST 2013
ReginaHolliday
@aliciabloom saw a great presentation by med. director at our hospice ondementia as infancy in reverse #hpm non clinical folks need a guide
Wed Feb 13 18:40:11 PST 2013
ctsinclair
I really like the page near the end of Caring Conversations (@PracBioethics) about trajectories: http://t.co/ZMORJuyB #hpm
Wed Feb 13 18:40:15 PST 2013
Kamiyamay
@CSlaterMD using phone :-) #hpm

Wed Feb 13 18:40:19 PST 2013
ctsinclair
@marlenatang Agree that hospice admission from the ED is tough, but not impossible with good collaboration between orgs. #hpm
Wed Feb 13 18:40:41 PST 2013
ReginaHolliday
RT @Kamiyamay: @ReginaHolliday we need a new default a better way. Early advocacy! #hpm
Wed Feb 13 18:40:41 PST 2013
KnowYourWishes
RT @aliciabloom: i think we need more stories like this out there: http://t.co/DwqGGf9V #hpm
Wed Feb 13 18:40:43 PST 2013
CSlaterMD
agree! RT @Kamiyamay: @ReginaHolliday we need a new default a better way. Early advocacy! #hpm
Wed Feb 13 18:40:50 PST 2013
chadreilly
Yes! Care decisions are fluid, not a constant @aliciabloom: T1- we need to have realistic conversations about disease trajectory... #hpm
Wed Feb 13 18:41:04 PST 2013
hospice_mktg
YES! RT @aliciabloom: i think we need more stories like this out there: http://t.co/bvqoExsY #hpm
Wed Feb 13 18:41:04 PST 2013
aliciabloom
@KnowYourWishes @marlenatang if you can find a good #hospice partner in the community, then d/c home w/ services from ED are possible #hpm
Wed Feb 13 18:41:12 PST 2013
PracticalWisdom
T1: Dr. Teno shared that Hospitals are Very complex Places when you are very Sick hard to advocate for yourself. Need An Advocate. #HPm
Wed Feb 13 18:41:21 PST 2013
ctsinclair
@marlenatang Agree, the default for a sick patient in the ED is 'admit & treat' or 'Admit & observe' #hpm
Wed Feb 13 18:41:45 PST 2013
13/22
2/14/13
KnowYourWishes
Only if ER docs willing MT @aliciabloom: @marlenatang if can find a good partner in community, then d/c home w/ services from ED possib #hpm
Wed Feb 13 18:42:23 PST 2013
napernurse
RT @PracticalWisdom: Patients wishes not be honored: Discussed #greatchallenges http://t.co/EeeAgVfK @TEDMED @CSlaterMD @hospice_mktg #HPM
Wed Feb 13 18:42:49 PST 2013
Kamiyamay
@PracticalWisdom so true Lisa. Once very ill I asked sign advance directives. Lg hospital. 6 hrs later said none avail to discuss #hpm
Wed Feb 13 18:42:50 PST 2013
ctsinclair
RT @PracticalWisdom: T1: @JoanMTeno shared 'Hospitals are complex places when sick; hard to advocate for yourself. Need an advocate.' #hpm
Wed Feb 13 18:42:56 PST 2013
ReginaHolliday
@PracticalWisdom Hospitals are a very scary rollercoaster when you are dying. #hpm
Wed Feb 13 18:43:02 PST 2013
RHR_Chat
T1 @PracticalWisdom Issue whether hospital advocate is really there for risk management. IMHO, need impartial advocate (maybe family) #HPM
Wed Feb 13 18:43:06 PST 2013
aliciabloom
T1- i'd like to spend the rest of chat talking about another news story today, so please share any final thoughts. . . #hpm
Wed Feb 13 18:43:41 PST 2013
ctsinclair
RT @ReginaHolliday: Hospitals are a very scary rollercoaster when you are dying "And a new culture that can intimidate the uninitiated" #hpm
Wed Feb 13 18:44:04 PST 2013
Kamiyamay
@ReginaHolliday dschg from ER and icu. Been there. Those ER docs luv to see hpm nurse come in. #hpm
Wed Feb 13 18:44:06 PST 2013
Kamiyamay
@RHR_Chat studying that. Takin coursework. #hpm

Wed Feb 13 18:44:40 PST 2013
PracticalWisdom
Dr. Teno "It's really important 4 you ask your Health care Providers to help you make a plan on how your Wishes are to be honored." #HPm
Wed Feb 13 18:45:33 PST 2013
ctsinclair
T1: Would love to see anthropological documentaries on hospitals to help patients and families understand medical culture #hpm
Wed Feb 13 18:46:00 PST 2013
14/22
2/14/13
PracticalWisdom
Agree. That's why HP & Proxy can help RT @ReginaHolliday: @PracticalWisdom Hospitals are a very scary rollercoaster when you are dying. #HPm
Wed Feb 13 18:46:21 PST 2013
MDelaCalzada
MT @ScrippsHealth Discover how Scripps hopes 2 help @SanDiegoHospice pts/staff, following Hospice's intent 2 close http://t.co/FSQOYo0i #hpm
Wed Feb 13 18:46:27 PST 2013
Amer_Acad_Peds
RT @nursefriendly: Wednesday #Healthcare #Tweetchats (ET) 8p #IVchat 9p #Premeded #HPM #DSMA #AddictionChat #DPTStudent #nurseup #rnchat ...
Wed Feb 13 18:46:39 PST 2013
SWChelsea06
@PracticalWisdom I agree- I think that Living Will and Power of Attorney forms are full of jargon and confusing #hpm
Wed Feb 13 18:46:58 PST 2013
aliciabloom
@PracticalWisdom even more than that, important patients talk WITH family about their wishes. ultimately, family must carry them out. #hpm
Wed Feb 13 18:47:04 PST 2013
Kamiyamay
@PracticalWisdom excellent. Must make sure all have documentation. That hospital etc have documented. Important as knowing allergies. #hpm
Wed Feb 13 18:47:22 PST 2013
Kamiyamay
MT @aliciabloom: @PracticalWisdom even more than that, important patients talk WITH family about wishes. family must carry them out. #hpm
Wed Feb 13 18:48:01 PST 2013
PracticalWisdom
I didn't say MT @SWChelsea06: @PracticalWisdom I think that Living WillPower of Attorney forms are full of jargon and confusing #HPm
Wed Feb 13 18:48:23 PST 2013
aliciabloom
T2- i'd like to spend the last few minutes of chat talking about a sad story that hit the news today. . . #hpm
Wed Feb 13 18:48:25 PST 2013
Kathy_Brandt
#hpm need people to name a surrogate not focus on living will. Join #speak4me http://t.co/46PWo3JT
Wed Feb 13 18:49:27 PST 2013
SWChelsea06
@aliciabloom I encourage my patients and families to give out several copies of their directives http://t.co/cFO9AYQp #hpm
Wed Feb 13 18:49:44 PST 2013
CSlaterMD
@ctsinclair fascinating idea. an anthropologic study of the culture of the hospital. Truly is a microcosm. would shed crazy insight #hpm
Wed Feb 13 18:49:58 PST 2013
KnowYourWishes
100% agree RT @Kathy_Brandt: #hpm need people to name a surrogate not focus on living will. Join #speak4me http://t.co/3rBuAbdn
15/22
2/14/13

Wed Feb 13 18:50:00 PST 2013
ctsinclair
Types of Adv Dir simplified: Living Will=Strong suggestions; Power of Attorney=Decision maker; DNR&POLST=Physician Order #hpm
Wed Feb 13 18:50:09 PST 2013
aliciabloom
T2- today we learned that SanDiego Hospice is closing, as they fell victim to Medicare audit. News story here: http://t.co/C5kR7oyv #hpm
Wed Feb 13 18:50:27 PST 2013
RHR_Chat
TY for info Kathy RT @Kathy_Brandt #hpm need people to name a surrogate not focus on living will. Join#speak4me http://t.co/zH7PrjC0
Wed Feb 13 18:50:30 PST 2013
hospice_mktg
Very sad news today about @sandiegohospice #hpm

Wed Feb 13 18:50:35 PST 2013
KnowYourWishes
Living will and advance directive not useful in isolation. Need surrogate who understands what was meant by it. #hpm
Wed Feb 13 18:50:49 PST 2013
PracticalWisdom
Alicia, @SandiegoHopsice News. This is terribly Sad. I know so many of us Hold them in High Regard. @aliciabloom #HPm
Wed Feb 13 18:51:04 PST 2013
aliciabloom
@ctsinclair well done in less than 140 characters! #hpm

Wed Feb 13 18:51:12 PST 2013
ctsinclair
@CSlaterMD would need it to be easily translated into helping patients and families understand, not just academic understanding. #hpm
Wed Feb 13 18:51:17 PST 2013
Kathy_Brandt
#hpm who will be @TEDMED? @NHDD is the same week. Let's plan some activities to get people talking about #acp #speak4me
Wed Feb 13 18:51:28 PST 2013
Kamiyamay
T2 when I read earlier today it evoked a strong emotion. Both mine and pts tweeting. #hpm
Wed Feb 13 18:51:31 PST 2013
NCHomeCareTim
RT @Kathy_Brandt: #hpm who will be @TEDMED? @NHDD is the same week. Let's plan some activities to get people talking about #acp #speak4me
Wed Feb 13 18:51:51 PST 2013
ctsinclair
T2: I am very saddened to hear about SD Hospice closing. For those who don't know SDH is one of USA's premiere hospices #hpm
Wed Feb 13 18:51:56 PST 2013
CSlaterMD
@ctsinclair yes, I imagine prime time viewers not grand rounds :) #hpm
16/22
2/14/13

Wed Feb 13 18:52:05 PST 2013
AHHCNC
Wed Feb 13 18:52:05 PST 2013
PracticalWisdom
RT @ctsinclair: T2: I am very saddened to hear about SD Hospice closing. For those who dont know SDH is one of USAs premiere hospices #HPm
Wed Feb 13 18:52:20 PST 2013
ctsinclair
I had my first #hospice experience at @ SDHospice. A lot of great leaders in the hospice field have trained there. Great teachers #hpm
Wed Feb 13 18:52:35 PST 2013
RHR_Chat
Wed Feb 13 18:52:48 PST 2013
Kathy_Brandt
@KnowYourWishes: Need surrogate who understands what was meant by it. #hpm Absolutely! #speak4me
Wed Feb 13 18:52:49 PST 2013
CSlaterMD
RT @ctsinclair: T2: I am very saddened to hear about SD Hospice closing. For those who dont know SDH is one of USAs premiere hospices #hpm
Wed Feb 13 18:52:51 PST 2013
PracticalWisdom
Agree @sandiegohospice Best Practice~Creative~Great Blog~Great Social Media Example for #HCSM. @ctsinclair #HPm
Wed Feb 13 18:53:36 PST 2013
ctsinclair
SD Hospice (like other hospices) was hit hard by Medicare fines. Complex issues, but really needs long form discussion. #hpm
Wed Feb 13 18:54:21 PST 2013
KnowYourWishes
@Kathy_Brandt Here is resource i created to help POAs understand how to interpret Advance directives #hpm http://t.co/bZ2hmNgO
Wed Feb 13 18:54:22 PST 2013
ctsinclair
@PracticalWisdom Yes SD Hospice has been a pioneer in health care social media for hospice. #hpm
Wed Feb 13 18:54:55 PST 2013
aliciabloom
T2- i think what happened to San Diego Hospice could happen to any hospice provider in the US. #hpm
Wed Feb 13 18:56:02 PST 2013
RHR_Chat
@RHR_Chat: @PracticalWisdom Realistically, where do patients go? Home? Who will be with them? @ctsinclair #hpm
Wed Feb 13 18:56:24 PST 2013
17/22
2/14/13
PracticalWisdom
So are there Trainings/Conferences to learn more about Lessons learned Re: @SanDiegoHospice ? @ctsinclair #HPm
Wed Feb 13 18:56:31 PST 2013
ctsinclair
RT @PracticalWisdom: @sandiegohospice Best Practice~Creative~Great Blog~Great Social Media Example for #HCSM #hpm
Wed Feb 13 18:56:33 PST 2013
aliciabloom
T2- the every changing and increasingly strict Medicare regulations around the hospice benefit present challenges #hpm
Wed Feb 13 18:56:44 PST 2013
HeartHouseHosp
RT @KnowYourWishes: @Kathy_Brandt Here is resource i created to help POAs understand how to interpret Advance directives #hpm http://t.c ...
Wed Feb 13 18:56:46 PST 2013
RHR_Chat
@RHR_Chat: @ctsinclair Where do we think most ppl get info? Forms from hospitals? http://t.co/hoyUk3pk? #hpm
Wed Feb 13 18:56:52 PST 2013
Kathy_Brandt
IOM Committee EOL 1st mtg is next week. http://t.co/BADLkXUx #hospice #HPM who is going/testifying?
Wed Feb 13 18:57:09 PST 2013
RHR_Chat
@RHR_Chat: @aliciabloomVery true, ALicia. But hard topic to bring up @PracticalWisdom #hpm
Wed Feb 13 18:57:14 PST 2013
Kamiyamay
@ctsinclair I hope as we move forward good balances injustice. Many losing care or lots of shuffling. Lessons for all #hpm
Wed Feb 13 18:57:32 PST 2013
ctsinclair
@Kathy_Brandt Would love for you to join in Tweet chat #hpm

Wed Feb 13 18:57:49 PST 2013
PracticalWisdom
Thank you. RT @Kathy_Brandt: IOM Committee EOL 1st mtg is next week. http://t.co/uWmw5lzs #hospice #HPM who is going/testifying? #HPm
Wed Feb 13 18:57:49 PST 2013
ctsinclair
@RHR_Chat Good question. I'm not sure. #hpm

Wed Feb 13 18:58:11 PST 2013
RHR_Chat
@RHR_Chat: @PracticalWisdom We all know best to make "wishes" when not very sick in hospital #hpm
Wed Feb 13 18:58:17 PST 2013
Kathy_Brandt
@ctsinclair: @Kathy_Brandt Would love for you to join in Tweet chat #hpm I listen more than join. Tonight just jumped in. Sorry!
Wed Feb 13 18:58:35 PST 2013
18/22
2/14/13
ctsinclair
@Kamiyamay @aliciabloom I imagine this will spark a lot of discussion of the Medicare Hospice Benefit and prognostic guidelines #hpm
Wed Feb 13 18:58:38 PST 2013
aliciabloom
@Kathy_Brandt we'd love to have you join in. . .anytime! #hpm

Wed Feb 13 18:59:12 PST 2013
RHR_Chat
@RHR_Chat: @Kamiyamay Cool. Let me know what you decide/learn #hpm

Wed Feb 13 18:59:13 PST 2013
ctsinclair
@Kamiyamay I'm hopeful that all the patients and staff can find a place to be safe. #hpm
Wed Feb 13 18:59:20 PST 2013
PracticalWisdom
Kathy were you talking about the #greatchallenges @TEDMED End of Life Discussion? @Kathy_Brandt #HPm
Wed Feb 13 18:59:29 PST 2013
ctsinclair
@Kathy_Brandt You are always welcome! #hpm

Wed Feb 13 18:59:36 PST 2013
aliciabloom
@ctsinclair i think that's needed, but i also think we have to be careful not to make it harder for patients to access the care. #hpm
Wed Feb 13 18:59:55 PST 2013
RHR_Chat
@PracticalWisdom We all know best to make "wishes" when not very sick in hospital #hpm
Wed Feb 13 18:59:58 PST 2013
Kamiyamay
@ctsinclair fun y wAs talking with an cc gaps surveyor about when chat started. Wishing best 4 all #hpm
Wed Feb 13 19:00:24 PST 2013
PracticalWisdom
Kathy or were you talking about http://t.co/3nkrINWm Day @Kathy_Brandt #HPm

Wed Feb 13 19:00:33 PST 2013
PracticalWisdom
Also Changes as our Health Changes too. RT@ RHR_Chat @PracticalWisdom We all know best to make "wishes" when not very sick in hospital #HPm
Wed Feb 13 19:01:14 PST 2013
RHR_Chat
@PracticalWisdom Realistically, where do patients go? Home? Who will be with them? @ctsinclair #hpm
Wed Feb 13 19:01:14 PST 2013
Kamiyamay
RT @Kamiyamay: @ctsinclair fun y wAs talking with an cc gaps surveyor about when chat started. Wishing best 4 all Sorry CHAPS #hpm
Wed Feb 13 19:01:34 PST 2013
19/22
2/14/13
ctsinclair
@RHR_Chat They will be offered choices of other hospices in the area. #hpm
Wed Feb 13 19:01:54 PST 2013
PracticalWisdom
EXCELLENT Chat. Thank you for our Topic, Folks who jumped in, Flexibility, ETC. @aliciabloom #HPm
Wed Feb 13 19:01:57 PST 2013
RHR_Chat
@Kamiyamay Cool. Let me know what you decide/learn #hpm

Wed Feb 13 19:02:16 PST 2013
aliciabloom
the hour has flown by & it was a lively discussion! thank you all for participating. please share final thoughts & join us next week. #hpm
Wed Feb 13 19:02:29 PST 2013
Kamiyamay
@RHR_Chat tough question. Will more faith based communities become involved? #hpm
Wed Feb 13 19:02:29 PST 2013
PracticalWisdom
Thank you Christian RT @PracticalWisdom: EXCELLENT Chat. Thank you for our Topic, Folks who jumped in, Flexibility, ETC. @aliciabloom #HPm
Wed Feb 13 19:02:30 PST 2013
ctsinclair
RT @aliciabloom: we have to be careful not to make it harder for patients to access the care. "Yes, and receive full benefit" #hpm
Wed Feb 13 19:02:49 PST 2013
RHR_Chat
@ctsinclair I'd like to see too #hpm

Wed Feb 13 19:03:15 PST 2013
Kamiyamay
@RHR_Chat got it. Sorry typos all. I am a keyboard person. Flexing my mobile muscle :-) #hpm
Wed Feb 13 19:03:24 PST 2013
ctsinclair
RT @Kamiyamay: @RHR_Chat tough question. Will more faith based communities become involved? "Potentially, but that is safetynet" #hpm
Wed Feb 13 19:03:27 PST 2013
PracticalWisdom
Hey you Guys lets give a hand to Alicia. It's not easy to Moderate a Tweet Chat. Takes Time, Talent & Skill! @aliciabloom #HPm
Wed Feb 13 19:03:42 PST 2013
aliciabloom
@RHR_Chat they may go home, if appropriate, with another hospice service or be transferred to another inpatient hospice setting. #hpm
Wed Feb 13 19:03:59 PST 2013
ctsinclair
@aliciabloom Great job hosting tonight! Good conversation. I had my plane mate take a picture of my doing tweetchat from the plane. #hpm
Wed Feb 13 19:04:04 PST 2013
20/22
2/14/13
aliciabloom
@PracticalWisdom thanks, Lisa #hpm

Wed Feb 13 19:04:40 PST 2013
ctsinclair
@Kamiyamay I just like to think it of as chicken scratch doctor handwriting. Eventually I can figure it out! #hpm
Wed Feb 13 19:04:40 PST 2013
KnowYourWishes
Goodnight #hpm. Been lurking the last few min. Great convo. Thanks @aliciabloom! #hpm
Wed Feb 13 19:04:42 PST 2013
CSlaterMD
@aliciabloom ty for discussion. learned a lot. thanks for sharing #hpm

Wed Feb 13 19:04:47 PST 2013
PracticalWisdom
MT @ctsinclair: I had 1st #hospice experience @SandiegoHospice # great leaders in the hospice field have trained there. Great teachers #HPm
Wed Feb 13 19:05:03 PST 2013
Kamiyamay
RT @ctsinclair: @aliciabloom Great job hosting tonight! Good conversation. (Applause) tough topics good convo #hpm
Wed Feb 13 19:05:05 PST 2013
aliciabloom
@ctsinclair awesome! we should chronicle all the places we participate from #hpm
Wed Feb 13 19:05:14 PST 2013
ctsinclair
@aliciabloom they have 400-500 patients on service, mostly at home, since they closed their inpatient unit #hpm
Wed Feb 13 19:05:26 PST 2013
RHR_Chat
@ctsinclair @kamiyamay And California is very unfriendly in #hc system lately. Ie lack of docs #hpm
Wed Feb 13 19:05:30 PST 2013
PracticalWisdom
RT @Kamiyamay: RT @ctsinclair: @aliciabloom Great job hosting tonight! Good conversation. (Applause) tough topics good convo #HPm
Wed Feb 13 19:05:36 PST 2013
RHR_Chat
@PracticalWisdom Realistically, where do patients go? Home? Who will be with them? @ctsinclair #hpm
Wed Feb 13 19:06:13 PST 2013
PracticalWisdom
Have you had a chance to see #greatchallenges @TEDMED End of LIfe? http://t.co/EeeAgVfK @ctsinclair #HPm
Wed Feb 13 19:06:27 PST 2013
ctsinclair
RT @aliciabloom: @ctsinclair awesome! we should chronicle all the places we participate from #hpm
Wed Feb 13 19:06:38 PST 2013
21/22
2/14/13
RHR_Chat
@ctsinclair Where do we think most ppl get info? Forms from hospitals? http://t.co/hoyUk3pk? #hpm
Wed Feb 13 19:06:47 PST 2013
Kamiyamay
RT @aliciabloom: @ctsinclair awesome! we should chronicle all the places we participate from #hpm
Wed Feb 13 19:06:53 PST 2013
PracticalWisdom
@ctsinclair Answered RT @RHR_Chat: @PracticalWisdom Realistically, where do patients go? Home? Who will be with them? @ctsinclair #HPm
Wed Feb 13 19:07:32 PST 2013
Robert_Fried
@SDHospice closure a tragedy with global implications. We need radical reform in way Medicare views #hospice and #eol care. #hpm
Wed Feb 13 19:08:11 PST 2013
Kamiyamay
@RHR_Chat chronicles. I've done Hpm in cow pasture in an RV poor peeps. Two of them. Where there is a soul we go! #hpm
Wed Feb 13 19:08:14 PST 2013
RHR_Chat
@PracticalWisdom @ctsinclair Mist of my clients are at home. #hpm

Wed Feb 13 19:08:35 PST 2013
nurse2103
RT @ctsinclair: I really like the page near the end of Caring Conversations (@PracBioethics) about trajectories: http://t.co/ZMORJuyB #hpm
Wed Feb 13 19:11:12 PST 2013
PracticalWisdom
CORRECTION: DR. Joan Teno used the term Proxy or Surrogate Decision Maker. I made a mistake Said Hospital Advocate. Sorry 4 Confusion. #HPm
Wed Feb 13 19:13:17 PST 2013
22/22

#HPM - TweetChat - 2/13/13

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#HPM - TweetChat - 2/13/13

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2/14/13

#hpm - Healthcare Social Media Transcript

welcome to #hpm tweetchat! let's get started with some introductions. . .

Hpm in motion. Lurking mostly. #hpm

#hpm - Healthcare Social Media Transcript

welcome @TheBiopsy! feel free to join in the discussion #hpm

@TheBiopsy Hi Roheet. Great name for a medical blog! #hpm

@KnowYourWishes Why, thank you! #hpm

hey @ctsinclair! #hpm

#hpm - Healthcare Social Media Transcript

@aliciabloom safety first. :-) know it will be A great hour. #hpm

@TexasKidDoc Good luck with that!! #hpm

Current pediatric resident going into nicu and #pedpc #Hpm

@TexasKidDoc hopefully long enough to join us for chat! #hpm

@CSlaterMD Welcome! #hpm

Hello #hpm. ER doctor from California here

@marlenatang welcome! glad to have you join us. #hpm

#hpm - Healthcare Social Media Transcript

Hello Everyone, Andrew Lopez, RN from New Jersey #hpm

T2 - very interesting it's not two divergent paths #Hpm

#hpm - Healthcare Social Media Transcript

@CSlaterMD I suspect it's a communication problem #hpm

@aliciabloom excellent point #hpm

#hpm - Healthcare Social Media Transcript

@PracticalWisdom @TEDMED @hospice_mktg Lisa, TY. amazing u are. #hpm

@nursefriendly @SWChelsea06 I was just on @MyDirectives today updating mine :) #hpm

#hpm - Healthcare Social Media Transcript

T1 Clinicians afraid to 'upset' patient perhaps reason for avoidance #hpm

#hpm - Healthcare Social Media Transcript

#hpm - Healthcare Social Media Transcript

at the end of the day it is the case by case #hpm

Can someone RT the first topic? #hpm

@aliciabloom Elaborate please . . . #hpm

#hpm - Healthcare Social Media Transcript

@KnowYourWishes Got it , thanks. no plan sets full press in motion #hpm

FYI Dr. Joan Teno is on Twitter @JoanMTeno #hpm

#hpm - Healthcare Social Media Transcript

RT @ctsinclair: RT @KnowYourWishes Full, aggressive intervention is the "no

#hpm - Healthcare Social Media Transcript

decision" decision #hpm "The default of the system" #hpm

@Kamiyamay was wondering what u meant! :-) #hpm

@ReginaHolliday we need a new default a better way. Early advocacy! #hpm

#hpm - Healthcare Social Media Transcript

@CSlaterMD using phone :-) #hpm

#hpm - Healthcare Social Media Transcript

@RHR_Chat studying that. Takin coursework. #hpm

#hpm - Healthcare Social Media Transcript

#hpm - Healthcare Social Media Transcript

Very sad news today about @sandiegohospice #hpm

@ctsinclair well done in less than 140 characters! #hpm

#hpm - Healthcare Social Media Transcript

#hpm - Healthcare Social Media Transcript

@Kathy_Brandt Would love for you to join in Tweet chat #hpm

@RHR_Chat Good question. I'm not sure. #hpm

#hpm - Healthcare Social Media Transcript

@Kathy_Brandt we'd love to have you join in. . .anytime! #hpm

@RHR_Chat: @Kamiyamay Cool. Let me know what you decide/learn #hpm

@Kathy_Brandt You are always welcome! #hpm

Kathy or were you talking about http://t.co/3nkrINWm Day @Kathy_Brandt #HPm

#hpm - Healthcare Social Media Transcript

@Kamiyamay Cool. Let me know what you decide/learn #hpm

@ctsinclair I'd like to see too #hpm

#hpm - Healthcare Social Media Transcript